Since the last few years, the news of widespread fungal infection – mucormycosis or black fungus in COVID-19 patients has taken everyone by surprise. Because of main digital media and social media providing round-the-clock discussion and sometimes showing pictures of patients suffering from these infections has led to fear in the society.
While the black fungus cases were spreading all over like wildfire news of four cases of white fungus in COVID-19 cases were reported from Bihar. Mucormycosis or black fungus is an uncommon fungal infection. The disease is often characterized by filaments like fungal growth in and around blood vessels and can be potentially life-threatening in diabetic or severely immunocompromised individuals. These fungi are found everywhere in soil, water bodies, old buildings, damp walls, etc. They may also remain in our bodies without causing any problem. Once body immunity goes down then these fungi may infect us from outside or if they are already in the body then they can start growing. That is why they are also called an opportunistic infection.
The most common site of infections is the brain, lungs, or sinuses. The fungus can also infect other areas of the body such as the gastrointestinal tract, skin, and other organ systems. The symptom of mucormycosis depends on the site of infections in the body. They can present as black patches as they cause the death of skin, they can cause fever, blindness, headache, swelling. The symptoms of mucormycosis also depend on where in the body the fungus is growing. These fungi can cause the destruction of organs as they tend to expand and erode through the surrounding wall of tissues.
Why COVID-19 patients are developing a fungal infection?
There are multiple reasons – COVID-19 patients have low immunity and unnecessary and prolonged use of certain medicines at high doses like steroids lead to further suppression of immunity. Unnecessary use of antibiotics may have the same effect. This decreased state of immunity in a patient provides the fungus an opportunity to invade the body and cause infection.
The other cause of infection may be the use of ordinary tap water or unclean water being used in humidifier which is used with Oxygen supply or used in a nebulizer. In this case fungus present in this water goes into the lung with oxygen or through nebulization.
In India, we have noticed and now the international health authorities have also raised the concern that in the treatment of COVID-19 infection standard guidelines and protocols have not been followed. Many patients are taking unnecessary antibiotics or steroids along with poor hygiene contaminated water in humidifier and nebulizer has caused the rapidly rising incidence of these diseases.
The treatment of mucormycosis will include specific antifungal infection along with surgical removal of the area if the fungus is localized.
The reports of white fungus are not surprising the mold or candida is a common infection but usually is not invasive. In the case of COVID-19 patients who are immunocompromised, these candida infections can spread in the blood and can affect any organs including the lung. The treatment is an antifungal medication.
These fungal infections are matter of concern and doctors have to formulate clear guidelines for management and people need to be vigilant and should report to doctor as soon as they notice any concerning symptoms. The mortality is very high if these opportunistic infections are not treated at an early stage.